Top Infectious Disease News of the Week—February 11, 2018

#5: WHO Sets Disease Priorities for 2018; Tuberculosis Once Again Not Included: Public Health Watch

Infectious disease specialists and public health professionals in search of a to-do list for 2018 need look no further.

The World Health Organization (WHO) has spoken.

On February 6 and 7, the WHO released its now annual list of priority pathogens for 2018. The first such list was introduced in December 2015.

Using a unique methodology that takes into account epidemic threat, ongoing research & development (R&D) initiatives, and drug/vaccine/device approval challenges, the international agency recommends that the following diseases and pathogens be prioritized for research and development in public health emergency contexts:

• Crimean-Congo hemorrhagic fever (CCHF)
• Ebola virus disease and Marburg virus disease
• Lassa fever

Check out the rest of WHO’s Disease Priorities for 2018.

#4: Could Flu Be Causing Hives?

Following the recent Facebook post of a mother whose son experienced hives soon before being diagnosed with the flu, health experts are answering questions on whether the virus may have caused the child’s rash.

Individuals infected with the influenza virus typically experience symptoms including fever, chills, cough, sore throat, runny nose, body aches, headaches, and fatigue. While flu symptoms can come on suddenly and range in severity, most individuals who catch the flu typically recover within 2 weeks. The Centers for Disease Control and Prevention (CDC) says severe illness and flu-related complications resulting in hospitalization and death are most likely to occur in young children, adults age 65 and older, pregnant women, and those with chronic health conditions and compromised immune systems. Such complications can include severe pneumonia, inflammation of the heart or brain, sepsis, multi-organ failure, and sepsis.

Read more about flu and hives.

#3: Influenza B Making a Surge in the United States

While influenza A viruses, particularly H3N2, have caused the majority of illnesses in the severe flu season of 2017-2018, health officials are reporting a nationwide rise in influenza B viruses, which can lead to some catching the flu twice in the same season.

In the FluView report for week 5 ending on February 3, 2018, the Centers for Disease Control and Prevention (CDC) reported that more than 30% of laboratory-confirmed flu-positive respiratory specimens were influenza B viruses. That’s well above this season’s average of about 20% and reflects what the CDC says is an increasing proportion of influenza B and H1N1 viruses being detected nationally. In a press briefing on February 9, CDC acting director Anne Schuchat, MD, RADM, USPHS, explained that it’s not uncommon to see a second wave of influenza B activity during an influenza season, and noted that the flu vaccine actually offers better protection against B viruses than it does against influenza A (H3N2), the predominant virus that has caused such a severe flu season this year.

Read more about influenza B.

#2: Diagnosis and Treatment of Chronic Lyme Disease: A Complex Issue

Recognition of chronic Lyme disease and the role of long-term antibiotic treatment for persistent symptoms continue to be controversial among researchers, providers, patients, and advocates. Improvements in the management of patients with Lyme disease will require an open-minded approach that includes multiple fields of medicine, according to experts who participated in a Peer Exchange^®panel.

Although the panelists agreed that awareness of Lyme disease has improved somewhat, they stated that the politicalization of the condition has prevented the development of well-funded clinical trials that are unbiased and clinically relevant and created an environment of fear among patients that their symptoms—often severe in nature—will be ignored by providers.

“Their greatest fear is not of having a diagnosis of chronic Lyme disease, but of not being able to have chronic Lyme as a diagnosis, because that prevents the physicians from treating them for the disease they really have,” said Patricia V. Smith.

Read more about what the experts are saying about chronic Lyme disease.

#1: IDSA & SHEA Release Updated Clinical Practice Guidelines for Clostridium difficile Infection

One of the most troublesome healthcare-associated infections that providers continue to struggle with in their health care facilities is Clostridium difficile (C. difficile). Luckily, advances have been made in the fight against the disease over the past few years, including the development of new diagnostic methods and treatments.

To reflect on these advancements, the Infectious Diseases Society of America (IDSA) and the Society for Healthcare Epidemiology of America (SHEA) worked together to release updated clinical guidelines for C. difficile in adults, and now, children. With these guidelines, health care providers can more effectively use the tools at their disposal to help improve patient outcomes.

The previous guidelines date back to 2010.

“These guidelines outline the preventive strategies for health care epidemiology and antibiotic stewardship,” Dale Gerding, MD, one of the authors of the guidelines told Contagion ^®. “But beyond that, they also change the recommendations markedly for diagnosis and treatment of C. difficile. Both of which, if followed, will result in better identification of cases and better management of those cases.”

Currently, a C. difficile diagnosis is based on several factors, such as patient medical history, symptoms, and, of course, test results. However, when it comes to identifying an optimal method of diagnosis, researchers cannot seem to come to a consensus. In fact, the topic has become quite controversial in the field.

The reason for the controversy lies in the tests available, according to Dr. Gerding. Molecular tests (ie, nucleic acid amplification tests [NAAT]) are used by more than 70% of hospital labs, according to a press release on the new guidelines. “Immunoassay (IA) testing for toxins was the test available prior to the emergence of NAAT testing,” Dr. Gerding explained, “And now, we seem to be swinging back toward more toxin testing, so the guidelines are an attempt to reflect that.”

Read more about the updated Clostridium difficile guidelines.